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.2017 Mar 8;17(1):54.
doi: 10.1186/s12866-017-0952-3.

Rapid detection of carbapenemase-producing Klebsiella pneumoniae strains derived from blood cultures by Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS)

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Rapid detection of carbapenemase-producing Klebsiella pneumoniae strains derived from blood cultures by Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS)

Christina Sakarikou et al. BMC Microbiol..

Abstract

Background: Carbapenemase-producing Enterobacteriaceae (CPE), particularly carbapenemase-producing Klebsiella pneumoniae isolates, are important causative agents of nosocomial infections associated with significant mortality rates mostly in critical wards. The rapid detection and typing of these strains is critical either for surveillance purposes and to prevent outbreaks and optimize antibiotic therapy. In this study, the MALDI-TOF MS method was used to detect rapidly these isolates from blood cultures (BCs) and to obtain proteomic profiles enable to discriminate between carbapenemase-producing and non-carbapenemase-producing strains.

Results: Fifty-five K. pneumoniae strains were tested. Identification and carbapenemase-production detection assay using Ertapenem were performed both from bacterial pellets extracted directly from BCs flasks and from subcultures of these strains. For all isolates, a complete antimicrobial susceptibility testing and a genotypic characterization were performed. We found 100% agreement between the carbapenemase-producing profile generated by MALDI TOF MS and that obtained using conventional methods. The assay detected and discriminated different carbapenemase-producing K. pneumoniae isolates within 30 min to 3 h after incubation with Ertapenem.

Conclusions: MALDI-TOF MS is a promising, rapid and economical method for the detection of carbapenemase-producing K. pneumoniae strains that could be successfully introduced into the routine diagnostic workflow of clinical microbiology laboratories.

Keywords: Blood culture; Carbapenemases; Detection; Klebsiella pneumoniae; MALDI-TOF MS.

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Figures

Fig. 1
Fig. 1
Mass Spectra of non-hydrolyzed and hydrolyzed Ertapenem and mass spectra of Ertapenem degradation after incubation with KPC, KPC plus VIM and OXA-48 producingK. pneumoniae strains at different time points, respectively. Molecular weight values of Ertapenem and its salt adducts peaks are indicated at the top of the peaks
Fig. 2
Fig. 2
Identification of a MALDI-TOF MS peak associated withblaKPC. Presence of the 11,109-Da peak in KPC-carryingK. pneumoniae isolate mass spectrum (fuchsia) and absence of an 11,109-Da peak in aK. pneumoniae non KPC-carrying isolate mass spectrum (green), respectively. This specific peak could be a helpful real-time marker in epidemic strain detection in a hospital setting
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